Provider Demographics
NPI:1609026210
Name:GLUCK, CATHERINE (PT)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:GLUCK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CATHY
Other - Middle Name:
Other - Last Name:GLUCK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:8827 CENTRAL PARK AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60203-1922
Mailing Address - Country:US
Mailing Address - Phone:847-554-1821
Mailing Address - Fax:
Practice Address - Street 1:8827 CENTRAL PARK AVE
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60203
Practice Address - Country:US
Practice Address - Phone:847-674-6612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-19
Last Update Date:2008-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070004756225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist